Phase 1 successfully addressed the feasibility of combining current research in learning theory, sensory stimulation and movement based communication training in a workable format for developing communication in at-risk children functioning below the 6 month level. Programs currently available are organized along normal developmental pinpoints. This program is a departure from traditional approaches because it is developed along a functional cognitive/physical skills matrix rather than along the normal developmental skills approach. Phase II will address the question of whether the manual piloted in Phase I, when completed and implemented, can change targeted behaviors. To answer this question the following objectives have been identified: 1. completion of all skill packets for all levels on the cognitive/physical skill matrix; 2. completion of a project developed, multi-dimensional, criterion referenced instrument to be used for test/retest (with inter-rater reliability of 90-95%); 3. implementation of a study (repeated measures design with delayed treatment or replication groups) with 50 to 60 children; 4. analysis of information gathered above using Wilcoxon and Mann Whitney design (with special consideration of threats to validity discussed later); 5. modification necessary before publishing; Phase III will be successfully completed when the above program is published.